Early Prediction of Acute Kidney Injury in Patients with Acute on Chronic Liver Failure by Measuring Kidney Injury Molecule-1 Level in Urine at Zagazig University Hospitals

Article 3Volume 9, Issue 3, September 2019, Page 207-215  

Document Type: Original Article

DOI: 10.21608/AEJI.2019.15780.1032

Authors

Ahmed A Wahdan1Ahmed M El-Gebaly email 2Soha E Khorshed2Mohamed E Farghaly2Heba F Pasha3Mohamed N Elkhashab2

1Tropical Medicine Department, Ahrar Teaching Hospital ,Zagazig, Egypt.

2Tropical Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

3Biochemistry Department,Faculty of Medicine, Zagazig University, Egypt.

Abstract

Background and study aim: Some of patients with decompensated cirrhosis will exhibit newly developed acute liver failure. This condition is called acute-on-chronic liver failure (ACLF). Acute kidney injury (AKI) is common with ACLF. Kidney injury Molecule-1 (KIM-1) is an ideal biomarker of AKI. The aim of this study was to evaluate role of KIM-1 in prediction of AKI in ACLF patients.
Patients and Methods: Eighty four patients were included in this study. They were selected from hospitalized patients with acute decompensated cirrhosis. They were allocated into two groups; group I: patients with no acute-on-chronic liver failure (ACLF), group II: patients with ACLF.
Results: KIM-1 was significantly higher in the ACLF (group II). KLM-1 median was 2.4 in group I vs 7.35 in group II with p value <0.001. We found that at cut off value of ≥0.5 KLM-1 can predict the presence of AKI with sensitivity of 85.7%, specificity 88.1%, positive predictive value 87.8%, negative predictive value 86%, accuracy 86.9% and AUC= 0.867 p <0.001.
Conclusion: KLM-1 rises significantly in patients with ACLF. KLM-1 can be reliable in prediction of the presence of acute kidney injury in decompensated cirrhosis.
 

Keywords

AKIACLFKIM-1non-invasivemarker

Main Subjects

Hepatology